Monday, September 24, 2012

Energion Political Roundable -- Q. 6 -- Medicare and the Presidential Candidates



The Energion Political Roundtable has reached round six, which as you’ll see focuses on the question of Medicare.  My conversation partners are   – Allan Bevere,  Elgin HushbeckJoel Watts, and Arthur Sido.  You can check out their responses, and if I have opportunity I’ll share my own responses.  So, on to the question posed by our publisher Henry Neufeld. 
Here in Florida we're getting a lot of political ads. One of the key topics in both the Senate race between Connie Mack and Bill Nelson and in the presidential race is Medicare. How would you evaluate the plans that each presidential candidate has for Medicare? Should senior citizens be concerned?

            Living in Michigan, which apparently has ceased being a battleground state, the ads aren’t coming as fast or as furious (no pun intended) as they are south of the border in Ohio or I presume in Florida.  As for the Senate race in Michigan, this particular issue (Medicare) doesn’t seem to be a major issue, at least at this point.  So, it’s possible that I’m a bit distant from some of the political wrangling that may be going on in other more contested spots – and/or states with large numbers of seniors.    

            As for my take on the ongoing Medicare debate, I should note that I see it in a broader context, which involves providing affordable health care options for all residents of this nation.  In the 2008 election the debate centered on whether access to quality health care was a right or not.  Both candidates seemed to agree that everyone should have access, though they differed to some degree on the delivery mechanism.  One of President Obama’s achievements was creating a national health care system, one that involves private health care insurers.  With this achievement in the background to our conversation we can turn to the current debate over Medicare.

            I think we can start with Mitt Romney’s declared opposition to the so-called “Obamacare,” even though it matches up with a rather successful Massachusetts venture.  I’ve never understood how he can say that it’s great for Massachusetts, but not for the rest of the nation.  If it’s so great, then why shouldn’t the Federal government emulate it?    Although the question before us has to do with Medicare, some of the President’s reforms of Medicare are predicated on the broader reforms of the ACA.  This is why Romney’s charges that Obama is “stealing” from Medicare are less than honest.  Obama is working to end inefficient delivery systems (overpayment to insurers through Medicare Advantage), and tying in those reforms into a more effective delivery system for Medicare recipients.  Obama’s plan is designed to extend the life of Medicare, even as costs are contained.  Benefits aren’t being reduced, their being extended and insurers are losing their government funded money pit.

As advertised the Romney/Ryan plan would retain the current system for those over 55, and then turn the system for those under 55 (I’m 54) into a voucher system, that most experts believe won’t keep up with inflation.  Now, supposedly the current system would still exist, but how would it exist if the funding source is changed?  None of this really is clear.  But more importantly, this is a political attempt to court older voters (who vote in larger numbers) by sacrificing younger ones.  As I understand it, many seniors aren’t interested in taking from their children and grandchildren. But more importantly, some analysts are suggesting that the Romney plan ultimately will bankrupt Medicare before the voucher program goes into effect.  So, maybe seniors should be concerned.

Now, am I completely satisfied with the President’s plan?  No.  There’s a plan that neither candidate has embraced, but one that likely will be implemented in time.  That plan is to extend Medicare to all.  If Medicare was offered as a health plan for persons of all ages, so that we’re paying into the system at a much younger age, when we’re less likely to make use of it, then the system has more funds to work with.  Of course, this plan has another name – “Single Payer System.”  It’s not politically palatable right now, but I think it is the most sustainable way going forward, if for no other reason that it can help contain the accelerating costs of medical care.  Such a system could move us from the current (and wasteful) system of pay per service method of delivery to one that is more holistic.  You know, doctors work as teams to find the best solution to a medical issue, and not simply order unnecessary and expensive tests or operations, simply because they make money from it.   If you remove some of this motivation from the system costs will be contained and better medicine will be practiced.  Oh, and as for those “death panels” and other scary things you’ve heard about, remember this – rationing happens all the time.  If you have the money or the insurance (and insurance companies ration all the time), then you can get what you want.  If not, well – you know!

            But the question is – what about the two candidates and their plans for Medicare.  If I have to choose a plan, I’ll go with the President’s.  I think that Romney’s plan will lead to disaster, while the President’s plan gives us some time to deal with the issue in a more effective way – when the political climate will allow us to move to a better plan.   
               

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